Scar Tissue

While Dr. Ernest DiGeronimo may have some patients who call him "wonderful" or shower him with gifts ranging from antique drawings to the expensive couch that adorns his waiting room, he isn't respected by certain leaders in the medical community (who won't openly criticize him). Additionally he currently faces charges of false advertising from the state's Agency for Health Care Administration.

Perhaps the biggest strike against DiGeronimo involves his credentials. Unlike most plastic surgeons who aspire to have first-rate practices, DiGeronimo "never bothered," he says, to become certified by the American Board of Plastic Surgery after he completed the University of Miami's plastic surgery program. "I just never needed it," he explains, because he had such an active practice from the very beginning. "Just because someone has certification and some more initials after their name doesn't make them a better surgeon," he insists, a view disputed by most medical experts. (Board certification involves passing a tough written exam and reviewing one's cases -- including before-and-after photos -- before a panel of board representatives based in Chicago. It doesn't involve direct observation of a candidate's surgery.) Some of his fellow plastic surgeons remain skeptical of him. Says one prominent local doctor, who asked not to be named, "If he's not board-certified, his skills are questionable."

These critics also note that he doesn't have hospital admitting privileges at any hospital near his office -- a sign, they assert, that he doesn't have sufficient respect or credentials to merit such access. DiGeronimo contends that since he never has needed to take a patient to a hospital in his more than fifteen years of practice, his admitting priviliges at South Shore Hospital on South Beach (generally considered a second-tier facility) are sufficient to allow him to handle any plastic surgery problem that might arise. And if there were such a medical emergency (a cardiac reaction, for example), his office staff could summon 911 to take the patient to the nearest hospital, he points out.

Despite the controversy, he wins praise from some colleagues and, most important, from his patients. Dr. Tim Alexander, who knew DiGeronimo when the latter was a plastic surgery resident and who does follow-up work for DiGeronimo when that doctor goes on vacation, says, "He's a very good surgeon." And the numerous patients who come back to DiGeronimo serve as another kind of testimonial. Perhaps the most striking endorsement comes from one patient who settled on DiGeronimo after extensive doctor-shopping: "In other waiting rooms, I always heard some complaints about the way things turned out, but not in his."

DiGeronimo has especially infuriated some of his peers with his high-visibility advertising. After being picked by the readers of South Florida magazine in August 1992 as "the best" plastic surgeon in Dade County, DiGeronimo took out ads trumpeting that fact. In the seemingly decorous world of medical professionals, where any kind of advertising still is viewed as faintly disreputable, DiGeronimo's ads struck a nerve. "He's flamboyant and arrogant," says one outraged doctor who asked to remain anonymous. "He's a hustler who disgraces my profession." (DiGeronimo and several other Miami-area plastic surgeons advertise in New Times.)

DiGeronimo, in turn, dismisses his critics: "There's a lot of jealousy among plastic surgeons. When you're on the top of the hill, someone's always trying to knock you down." Moreover, he insists, "My advertising is tasteful."

The complaints, though, were taken seriously enough to lead to an investigation by the state Department of Business and Professional Regulation. Last year that agency charged DiGeronimo with violating Florida's medical practice code by engaging in false and deceptive advertising, particularly because he hyped his "superior" and "fabulous results" -- and claimed that Mirinka, who does make-up tattooing in the same suite and uses anesthetic drugs (administered by DiGeronimo) on her patients, was a "dermalogist." This is a European term for what is actually a glorified tattoo artist; state regulators were concerned that this title implied she is a medical professional. Another complaint filed by the state accused him of exaggerating the value of a surgical tool he invented, a variation of the standard cauterizing instrument. Although the doctor says the charges against him currently are being "resolved," Monica Felder, the Agency for Health Care Administration attorney who is pursuing the deceptive advertising case for the state, says she's still seeking to impose fines and other sanctions, such as a letter of reprimand, on the doctor. DiGeronimo's attorney is seeking to have the case dismissed.